去勢抵抗性前立腺癌に対するカバジタキセル療法の治療成績とサルコペニアとの関連についての検討

Abstract

Sarcopenia is a known predictor of overall survival in several diseases. We investigated the relationship between sarcopenia and outcome of treatment with cabazitaxel (CBZ) for castration-resistant prostate cancer (CRPC) by a retrospective analysis of 37 patients, who were given cabazitaxel at our hospital, from December 2014 to November 2020. The skeletal muscle mass was evaluated using the Psoas Muscle Mass Index (PMI: psoas major muscle area at the level of the third lumber vertebra (cm²)/height x height (m²)) through computed tomography images. The severe sarcopenia group (PMI＜4.96) showed lower levels of serum albumin, in comparison with the non-severe sarcopenia group (PMI≥4.96). Multivariate analysis identified PMI (odds ratio＝3.7; P＝0.023) as an independent factor associated with prostate specific antigen response to CBZ therapy. However, there was no significant difference in the overall survival between the severe and the non-severe sarcopenia groups (P＝0.1). Skeletal muscle mass might be closely correlated to the therapeutic response to CBZ, but not to the prognosis of patients with CRPC. Nutritional rehabilitation and exercises targeting sarcopenia for patients with prostate cancer should be considered.